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Network Adequacy: Action Alert

If you’ve been following the Peach Pulse you know that network adequacy is a hot topic in health care right now. (And if you missed it, check here and here to get caught up!) Decision-makers are weighing policy choices that will have implications for health care consumers in Georgia and across the nation. We know that they are hearing from health industry stakeholders; now they need to hear from you!

 

1) The US Department of Health and Human Services (HHS) Proposed Rule on the 2016 Notice of Benefit and Payment Parameters is open for comment until December 22, 2014.  To submit a comment, click here.

 

2) The National Association of Insurance Commissioners (NAIC) is currently updating its model act on network adequacy. This model provides an example that states can use to enact their own legal protections to guarantee private insurance consumers an adequate provider network once they are enrolled in coverage. Advocates can email jmatthews@naic.org until January 12, 2015 with input.

 

Consumer advocates are asking these two entities to put in place 1) specific network adequacy standards such as time and distance standards and appointment wait time standards and 2) rules that provide consumers the right to go out-of-network at no extra cost if their plan cannot provide them timely, geographically accessible, and appropriate in-network care. Please take a few moments to submit your comments to HHS and to the NAIC with this important request. If your organization is interested in engaging more deeply on this issue, please contact Laura Colbert at lcobert@healthyfuturega.org to let us know you’re interested in collaborating.

 

 

 


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